by Wyn Staheli, Director of Research
February 21st, 2017
Telehealth (also known as telemedicine) is playing an ever increasing roll in the reimbursement process. Internet services continue to expand and many insurance payers/providers are now covering (paying for) telehealth services. Telepsychiatry (providing behavioral health services in a telehealth environment) has been highly successful because video conferencing makes providing psych services as relatively simple and inexpensive process.
The Resources section below includes links to documents which give further instructions and guidelines on providing psychotherapy services in a telehealth environment.
Telehealth began as a way for rural areas with limited access to health care to be able to get the services they need. As internet access becomes faster and the cost of providing telemedicine services decreases due to equipment and service cost decreases, this expansion not only allows patients to receive better access, it also allows providers to reach an new market.
As with all new technologies, guidelines and quality of care are extremely important. In 1998, The American Psychiatric Association board approved some guidelines on quality of care as it relates to providing telemedicine. The entire document may be downloaded from the resources section below:
Effective January 1, 2009, Medicare further expanded telehealth services by adding three new follow-up inpatient consultation codes. G0406-limited, G0407-intermediate, and G0408-complex. The initial consultation may be in person or via telehealth. To read more about Inpatient Telehealth Consultations, see the resources below.
Effective January 1, 2014, Medicare again expanded telehealth services to include 99495: Transitional Care Management Services (99495 and 99496). These codes must be submitted with modifier GQ or GT for professional services. Critical Access Hospitals (CAHs) should elect Method II on Type of Bill 85X.
When billing G0406-G0408 you may not use additional Evaluation and Management codes. They must also be billed with the appropriate modifiers. You must also meet the "Originating sites" qualifications when billing Medicare. Modifiers and additional information are included in the Reimbursement Guide for Behavioral Health - available in the online store.